She was 26 years old, just back from five years in Japan and running her own export business in the ski paradise of Jackson Hole, Wyoming.

She was just a little bloated…and her lower back ached. In fact, she had a lot of PMS-y symptoms—but they didn’t ever go away.

Still, Elizabeth Mannen was young and healthy and fit; she hiked and biked and skied; she knew of no family history of cancer, wasn’t even thinking cancer when she drove four hours south to Salt Lake City.

She’d already seen four doctors, and they weren’t thinking cancer, either. Certainly not ovarian cancer, which usually hits post-menopause.

But the fifth doctor did a scan.

“He gave me a six-month prognosis; essentially said, ‘Go home and get your affairs in order,’” she says. “I was 26—I didn’t have any affairs, except after too many cocktails at the cowboy bar!”

Mannen’s parents wanted her to come “back to the East Coast where the real” doctors were.” She shook her head. “My soul sings here.” After five years in crowded Japan, she’d relaxed into the West. Ironically, she’d never felt more alive. “If I only have six months to live, I’m going to spend them here,” she said. “And if I’m going to fight to live longer, I’ll be in my best frame of mind here.”

She found another doctor in Salt Lake, one who had a blunt optimism: “I’ll slice and dice you and fillet you like a fish,” he warned, “remove what I can and poison you to within an inch of your life, and we will see.”

“OK,” she said. “Game on.”

She told her boyfriend at the time the news. He broke up with her, said he hadn’t signed up to be with someone who was sick.

They’d been sharing a condo, so now she was homeless. Jobless, too, because she couldn’t continue keeping Japan’s business hours if she was going to make it through chemo. She rented a room in a woman’s house and prepared for surgery.

Afterward, she thought, “I need a raison d’etre. I can’t just sit here and watch my hair fall out.” So she applied for a job as a part-time file clerk at A.G. Edwards.

The guy who interviewed her said, “Tell me a story.”

She murmured something about knowing the alphabet and being conscientious.

He demanded a story—a true one.

Finally she said, “Sir, I don’t know what you want.”

He said, “Young lady, this is a small town. I’ve watched you come in, open a business, and make a ton of money in the first year. The check you write every month to [a property company]? That would be me.” He propped his cowboy boots up on his desk. “You have an Ivy League resume—you’re way overqualified to be a file clerk. I want the truth.”

She explained about the cancer and the chemo, said she desperately needed a distraction, and assured him that she’d be recovered from the Friday session by Tuesday mornings.

“If you don’t feel good in the morning, come in in the afternoon,” he said. “And if you’re bored on Mondays and Fridays, come on in then.”

Two weeks later, he fired her.

“You’re far too smart for a file clerk,” he said. “You ask too many questions.” He plunked the Series 7 books in front of her and told her to study to become a financial advisor.

Today, Mannen, 53, is the managing director of investments at the Mannen Financial Group of Wells Fargo Advisors (which bought A.G. Edwards).

It was at A.G. Edwards that she met Bill Mannen, who flew out to Jackson Hole from St. Louis to do some training just as she was finishing her chemo. He asked her out.

Running a finger through hair about an inch long, sure she looked like a little withered bird, she said, “I’m 18 months past my expiration date. I’m barren. I’m not good dating material.”

He said, “And I have something to tell you.”

He’s married, she thought. But instead, he said, “I’m raising young boy-girl twins.”

She grinned. “You win. I’m outta here.”

Except, she fell in love with the twins. And their dad. Eighteen months later, she married all three of them, up on the altar together.

Then, when Mannen was 35, her ovarian cancer came back. “It’s a chronic cancer,” she explains. “It’s very hard for it go go away.”

Chemo prevailed. And it prevailed again when the cancer returned three years later. And four years after that, when she was diagnosed with breast cancer. And in 2012, when she developed breast cancer again.

“For most women, having both ovarian and breast cancer would suggest they were BRCA1 or BRCA2 gene positive,” she says. “I’m not. I’m just lucky.”

Her tone’s sarcastic—but then she begins listing all the ways she is lucky:

“I’m in St. Louis, where you have Siteman Cancer Center and internationally known physicians like Dr. David Mutch and access to clinical trials. I have corporate healthcare that says yes to everything. I’m educated, and I understand how to be my own advocate. Some people aren’t willing to switch their doctor; they say, ‘Oh, but she’s so nice.’ I want the best doctor; I don’t care if she has the personality of a rock. I don’t need to love her. She just needs to be the best damned doctor. If she’s kind too, like Dr. Mutch, that’s bonus.” She takes a deep breath. “So those are all reasons I am alive and other women are dead.”

Now divorced, Mannen volunteers tons of time coaching other women through cancer. “Ovarian cancer has such nebulous warning signs that it’s usually discovered late-stage.” She goes through the signs: “Bloating, whatever’s not your normal. Change in bowel habits. Indigestion and nausea that are not normal for you. Pain in your abdomen or pelvis. A lump in your abdomen. Extreme fatigue. Weight loss. Sometimes lower-back pain. Menstrual irregularities.”

Early detection’s key. So is remembering that “this is not a death sentence,” she says. “It’s obviously very disruptive. But it teaches you how to live.

“Perspective fades, of course. You find yourself complaining about traffic and corporate mergers and the fact that no one in your house changes a roll of toilet paper except you. But I do live every day with intention and purpose. I try to live every day twice before I put my head on the pillow.”

September is National Ovarian Cancer Awareness Month, and the signature color is teal. The schedule of events sponsored by St. Louis Ovarian Cancer Awareness:

Tuesday, September 4: Bake cookies for survivors in the Dierbergs Cooking School kitchen in Des Peres. They’ll sweeten the day for patients and oncology nurses at area chemo centers.

Tuesday, September 11: Teal Toes. Reserve a pedicure at the Nail Pro in Des Peres for the Teal Toes event (and no, you don’t have to choose a shade of teal). Raffles, prizes, and treats all day. Teal Toes is organized by the friends and family of the late Shawn Blaes. Last year, the event raised more than $6,000 to fund ovarian cancer research.

Friday, September 14: SLOCA Night at the Ballpark. The Cards take on the Dodgers at 7:15 pm, and the crowd joins the fight against ovarian cancer. Details here.

Sunday, September 23: Ovarian Cancer: Survive and Shine Course. At The J Community Center in Creve Coeur, 9 a.m. – 1 p.m. A free educational event for survivors and caregives, with sessions on genetics, diet and nutrition, side effects and stress. Breakfast and lunch included. Pre-registration is required

Sunday, October 14: The 12th Annual Families Run for Ovarian Cancer. Presented by TESARO, the 5K and 1-mile run/walk take place in downtown St. Louis. The race starts at 8:30 am at Soldiers Memorial, 1315 Chestnut Street, after a brief ceremony.